Deconstruction of "Z-Health Performance Solutions"

[bernard]

Well Mike,

Thanks again for the references but they are evidences, even for a child of five. It is well known that my head is more sensitive than my a... sorry my lower back.

Unfortunately these references contradict the words you wrote.
If I was following your "theory" (it is impossible at the moment), moving a "sensitive" joint will be more effective than "drilling" a less sensitive one?

It will be more effective to take care of the cervical area since it has some priority over the lower compartments. We are, as PTs, convinced that sometimes it works but often it don't. Our deep model is just more complex...

The examples given give another contradiction since you move a whole limb, as so, you have no way to insure the real participation of one joint over another one.

[Jason Silvernail]

We're getting along so well, but....

Geoff-
I hesitate to bring this up, because we're at a positive place here at the thread.
However, you've said some things on your blog regarding this discussion that I have to address, as I think it will help not only you, but other readers understand better the fundamental issue we're having with Z and your approach to it. I'll put your statements in quotes.

I love Physical Therapists. (Obviously, I'm married to one.) However, the unfortunate trend in their "industry" is to wait for scientific evidence (i.e.: formal, published experiments) to validate efficacy of any technique, idea, etc. This is what they call "science." This is not science. This is called the "experimentation" part of the scientific method. The scientific method STARTS with observations, or anecdotes. Much of what "science" "confirms" we in the field already know through intuition, observation, experience, and results. In my opinion, if we waited for science to "validate" everything, we'd never get anywhere!

No one has asked for validation of Z. Validation would be a study, such as a randomized controlled trial or published experiment, demonstrating superior outcomes compared to other training methods. Neither you nor any proponent of Z has been asked for this. We've only asked whether the claims can be explained in terms of human physiology, how the system is different than other systems, and why it's worth it's high cost. This is not a request for validation, it's a request for it to make sense.
Barrett has covered earlier the fact that anecdotes have nothing to do with the scientific method.
I would say that PTs in general do NOT wait for something to be validated before they use it, they just have a cautious and skeptical approach to things. Or at least they should, if they take their training in science and therapy seriously.

Liberal Arts v. "Hard" Science: My wife and I are 2 extremes in the academic world. My background is liberal arts (LA): history and philosophy. Hers is exercise science. The trend is seems over the last 30 years is that in the "hard" sciences, students are taught what to think, not how to think. The LA education teaches students how to think. This drives my wife nuts. I thought I was stupid in chemistry and struggled to get Cs. She got As. By her own admittance, she's great at memorizing. I am not. Where am I going with this? It seems that she's not alone in her field. Many PTs that I've met wait for "science" to prove something before they even experiment with it. How's this relate to Z? Dr. Cobb has drawn from the fields of neurophys, neuroanatomy, motor learning, etc and taken concepts that appear to be unique to each and tied them together. How is that special? Because he knows how to think, not necessarily what to think. Is this a slam on PTs? No. It's a slam on the educational system that values regurgitation of ideas instead of the exchange of ideas.

While I won't disagree on the value of a liberal arts education (I have one too), this "what to think vs how to think" position of yours is inaccurate when applied to this system. Far from "how to think", Dr Cobb seems to have provided his students (you and others) with EXACTLY what to think - as you all are accepting the results and explanations for your system without really understanding why you're doing what you're doing, or why that might be helpful, or why it's different from other approaches. Not to mention there's been little or no effort to explain anecdotes such as Courtney's Deadlift and Hammertoes stories with any thing substantive. If anything has been, to use your phrase, a "regurgitation of ideas", it's the stories and attempts at explanation found by proponents of Z.
I say Dr Cobb "seems" to have provided because he hasn't appeared here to explain things himself.

I don't care if I'm right or wrong here. I care about results. Until someone who's not using Z can prove to me that what I'm doing with Z doesn't work, that individual's not gonna get me to stop. Again, for me personally and professionally, it's all about results. Z gets me the results I want and my clients demand. How else can I stay in business? If Z fails me, then I'll move on to something else. Does that sound mercenary. You bet.

Well, I would hope you care if you're right or wrong. What would you accept as "proof" that Z doesn't work? We've done a pretty good job here showing that Z doesn't make sense - I would hope that's enough. Your "results" you're so proud of are to be found in many approaches. Everybody has claims and stories that their system is the best. Without any true understanding of why things work, you will simply hop from new system to new system, filling your toolbox with increasingly useless and contradictory approaches. You don't lack for results, Geoff. You lack understanding. You're a smart guy, and if you build that "basic science" kind of understanding, you'll be in a position to really evaluate new things for their soundness before you jump in with tons of money and start drinking the Kool Aid.

That will make you a better trainer and a better athlete - and you will be a much better resource for your clients as well.
What do you think?

[Keats Snideman]

I'm not sure if the Z-health proponents are going to be contributing to this thread any more? If only Dr. Cobb would join in.

On another note, having just returned from a CPR/AED re-ceritifcation class ealier tonight, I was reminded just how important the brain and an oxygen supply for it is. We were then reminded that ribs and cartilage will probably be broken during chest compressions and that it's OK since the person has bigger problems at the time (no need to mobilize cuboid bones).

This made me realize (again) that "survival" is the real goal for the brain and nervous system. If neural tissue is being deprived of oxygen (for whatever reason) the body will compensate (even harmfully distorting posture and joints) to maintain nervous tissue integrity.

[Keats Snideman]

This thread has motivated me to revisit Carl Sagan's Baloney Detection Kit (as laid out in his 1996 book The Demon Haunted World, Science As A Candle In The Dark). Here are some of the key questions to ask according to Sagan:

*Wherever possible there must be independent confirmation of the facts

*Encourage substantive debate on the evidence by knowledgeable proponents of all points of view.

*Arguments from authority carry little weight (in science there are no "authorities").

*Spin more than one hypothesis - don't simply run with the first idea that caught your fancy.

*Try not to get overly attached to a hypothesis just because it's yours.

*Quantify, wherever possible.

*If there is a chain of argument every link in the chain must work.

*"Occam's razor" - if there are two hypothesis that explain the data equally well choose the simpler.

Ask whether the hypothesis can, at least in principle, be falsified (shown to be false by some unambiguous test). In other words, it is testable? Can others duplicate the experiment and get the same result?

[toddhargrove]

Well even though this thread seems dead, and that is probably a good thing, I decided to write down some final thoughts. I thought I’d start by trying to answer what seemed like the main questions the soma crowd had regarding Z and then move on to some other thoughts. Here’s goes.

Why is Z unique? I thought about this for a while and came up with the following. I think that z is uniquely better than other comparable therapies out there for the following reasons, which are pretty simple. I hesitate to write this because I feel like these points have already been made, but Randy’s comment that Z is somehow like Crossfit or Probodx (huh?) makes me think that there is still a communication gap here. In my mind there are three essential elements to Z that (as far as I know) make it unique.

(1) Z focuses on improvement of motor patterns, instead of just trying to lengthen/strengthen the muscles that Janda or Kendall said needed to be lengthened/strengthened. Of course, many other exercise programs also do this, but they do not also do the following.

(2) Z uses very subtle gentle movements with a very strong emphasis on quality and precision of movement as opposed to ROM or force of movement. Z movements must be done with great concentration and awareness of subtleties in the movement. I think this is essential for learning new motor patterns as opposed to strengthening existing ones. I am aware of several other therapies that have this emphasis, including feldenkrais, Alexander technique, somatics, and tai chi. I think these therapies are all great, but none of them, to my knowledge, have the third element which I believe sets Z apart.

(3) Z recommends starts with isolated movement and then moves to integrated movement. Z is set up to recover normal coordination and movement at each joint in an isolated manner before moving on to integrated and more complex multijoint movements . My understanding is that feldenkrais, somatics and tai chi all typically involve movements over several joints at once. The rationale behind Z’s isolated approach is that integrated movement will necessarily lead to compensations and “cheating” that will fail to correct poor coordination at the weak joints in the movement chain. Z methodically covers each joint and ensures that each joint is challenged to move through its full ranges of motion in a coordinated and controlled fashion, BEFORE moving on to more integrated movements. I’m not aware of any other therapy that does this, and to me this is the main thing that sets Z apart. A very simple distinction, but an important one in my mind. Another possible benefit of the isolated approach is that it makes it easier for a trainer to teach movements, prioritize the important ones, and do assessments.

Why is Z training worth the money? First of all, I don’t really see how this question is relevant for a board devoted to science and not consumer protection. But if you want my answer, I would offer the following facts to explain my experience with level one training and why I thought it was well worth the money.

The first level of Z lasted six eight hour days. There were between 8 and 10 students in the class, all of whom were personal trainers, except me (I’m a manual therapist). Dr. Cobb was assisted by two to five instructors at all times. The teaching covered many topics, many of which were relatively unfamiliar to trainers (but not PTs), including the SAID principle, the startle reflex, basic neurology, proprioception, nociception, motor learning theory, sensory motor amnesia, and arthrokinetic reflex. These topics were presented in a way that was accessible, relevant and useful to the trainers present. A good deal of time was spent discussing how these principles are routinely ignored or violated in common training programs. Numerous physical demonstrations were provided which attempted to illustrate the principles. A great amount of time was spent learning how to perform and coach each of the numerous mobility drills for each joint. Throughout the weekend, Dr. Cobb offered numerous random bits of interesting information on a huge variety of topics drawn from his extensive experience with martial arts, athletic training, special forces training and working as a manual therapist. This aspect of the weekend was of considerable worth to me.

As to the worth of the other levels of Z training, I can’t really comment in detail because I haven’t attended. Based on what I know though, the second level involves integrated movement and visual and vestibular techniques, the third level is called “Sport Specific” and involves using Z principles to teach sport specific movement, including sprinting, cutting, etc. The fourth level is for manual therapists only. I assume it discusses some neurodynamics and pain science because Butler and Shacklock are on the reading list. Dr. Cobb has also mentioned that his manual therapy is largely based on skin stretch techniques. These facts seem to offset Diane’s concern that Z is hopelessly mired in a mesodermal perspective as opposed to an ectodermal one. In any case, the different levels of Z do not appear to be a way to “hook” suckers into a scientology like scheme, as has been suggested in previous posts.

How Z results can be Explained in terms of Physiology. Again I’m hesitant to write this part because I think it has already been covered by me, Courtney and to some extent Randy. Surprising and/or immediate reductions in pain after joint mobility work can be explained by several mechanisms. Proprioception overwhelming nociception is one way. Alteration of motor patterns or body positions reducing mechanical deformation of nerves is another. These two mechanisms should be able to explain quite a lot, including, I assume, many of the good results that come from Simple Contact, DNM, and any other therapies which the Soma crowd would approve. There could be other mechanisms such as autonomics, placebos or other more psychological stuff but I would think that these would not be unique to joint mobility and would apply in almost any relaxing therapy. There may be other mechanisms for joint mobility work reducing pain but I am unaware of them. I asked others here to volunteer their reasons and nothing was offered, except Randy’s summary of how Z might work, which sounded fairly accurate. (Of course I completely disagree that with Randy’s idea that Z is somehow like Crossfit or Probodx. Why not throw in the thighmaster and Richard Simmons Sweating to the Oldies?)

There are a couple other issues I wanted to get off my chest. The tone taken by some posters seemed to imply that it was somehow a huge problem that three or four random Z trainers were unable to explain to some PTs on a forum, with no prior notice, exactly how Z works at the deepest level of science. Most orthopedic surgeons could probably not meet this standard and they are cutting people. Z trainers are are just giving people some simple and very gentle mobility drills. They very strongly emphasize that that the client should NEVER move into pain. Common sense and well established science suggests that the drills have a good chance of helping people with their pain and performance. Its not a major crime if the Z trainer can’t immediately explain to the client or some PTS exactly what is the mechanism for the results. Sure it would be better world if we all had as much knowledge as the soma crowd of pain science (and could somehow translate this to clients) but lets put this in perspective. At this time you can’t expect everyone to read and understand Ramachandran, Damasio, Wall, Butler and Shacklock and translate this to a client before trying to help them with their aches and pains in a gym.

I also disagree that “no personal attacks occurred” or that there wasn’t any “sarcasm, hostility or cynicism.” Well maybe we could disagree on exactly what these terms mean, but there is no dispute that: Z was compared to scientology; mocked as being like star trek; it was stated that “Z is an abbreviation for zero”; that Z training is for “suckers”; and there were other references to “quackery”, a “five year old” mentality etc. I agree that the Z website marketing raises suspicion, and I think its perfectly appropriate to approach Z (or anything else) with skepticism and a lot of good questions and demands for evidence. Vigorous debate is absolutely necessary for the advancement of science. And each participant has to have a thick hide, be prepared to deal with cognitive dissonance, etc. But, there’s no reason to be demeaning, sarcastic, or to assume the worst about people or things before really getting a good idea of what and who you’re condemning. I think it would have been great if Dr. Cobb appeared on the forum to offer his thoughts. I can’t help but think it would have been a lot more likely without the sarcasm, mockery and presumption of guilt.

That being said, I don’t want to overlook the fact that many of the posts were well intentioned helpful and courteous, and that there was some valid and constructive criticism offered by the soma posters which I found useful. Thanks for that.

[Jason Silvernail]

Hi Todd.
I appreciate the effort you've made here.

On how Z is unique:

Nothing, and I mean nothing, you've said here about Z is in any way unique. In fact, the NASM's Optimum Performance Training Model (which I am in no way endorsing) talks about your third point in detail, and is primarily aimed at trainers and coaches as well. Contemporary motor control theory suggests that the body moves in ways that are goal oriented, rather than joint oriented. That's a bit of a problem if we're going to try to break movements down into individual joint movements first and pretend that's a superior way to learn.
Your first two points are covered by any modern training system or by anyone who trains athletes or clients for a living. I can imagine the trainers and therapists at the Z seminar: "Oh, it's a motor pattern we want? You say the movement should be learned with good quality first before it's loaded? Wait, wait, let me write this down, this is so unique..."
I mean, seriously?

On the cost of Z:

No one here is playing the "protect the consumer" card, actually. However, given the large numbers of expensive "systems" in the training and therapy world that are based on outdated or simply inaccurate concepts, a large amount of suspicion is warranted given the claims that are made. Now, if someone was teaching a course or program that made scientific sense and had demonstrated superior outcomes, then that would be something entirely different.
But opinions aside, it's not wrong to wonder what people are getting for the money. Or not getting, as the case may be.

On Explaining Z Results

Surely you've got to be kidding when you say this has been done. It has neither been covered by you nor Courtney, and Randy's post that I believe you are referencing simply summarized the proposed mechanisms behind joint-focused movement and therapy systems of all kinds. Attempts to explain Z have thus far consisted of sentences with scientific-sounding words in them but without making an actual argument or describing a chain of events. That's why I thought the Star Trek example was worth relating. The anecdotes brought by Z proponents (especially Dr Neupert) were met with requests for an explanation, which was never given. Saying the words "proprioception", "the nervous system", and "arthrokinetic reflex" is not an explanation.

I find it particularly funny that you think Z has nothing to do with ProbodX or Crossfit, since many of the general ideas about proprioception, mobility, the SAID principle and motor patterns are as prevalent in those "systems" as in yours. No case for uniqueness has been made by a Z proponent.

No personal attacks have been made by anyone here. Not one.

there is no dispute that: Z was compared to scientology; mocked as being like star trek; it was stated that “Z is an abbreviation for zero”; that Z training is for “suckers”; and there were other references to “quackery”, a “five year old” mentality etc.

This is a group of scientists. Larger than life marketing materials with little substance, outrageous claims without evidentiary support, the apparent reliance on big words to attempt to convey arguments - these seem to fit Scientology and Star Trek pretty well. None of this started until pretty far into the thread when people, after being asked sensible questions, bombarded this board with regurgitated marketing lines and anecdotes.

Look, I don't expect everyone to have deep knowlege of everything before they do anything. I can pretty confidently say I'm the least educated mod here in those areas. But at least an effort would be nice. Additionally, Geoff's claim that he could help people with this system that educated and credentialed health care providers couldn't surely added to the overall tone of Z that we saw here.

I'll say it again - if I went to the Supertraining listserv or the NSCA discussion board and made the kinds of claims about performance training that others made about pain relief here, and gave similar explanations to what Z health proponents did, those well educated sport scientists and strength coaches would tear me apart. That's what scientists do.

Complaining of cynicism, hostility, and personal attacks which have not been made does not change the basic fact that no convincing case has been made for the merits of Z.
I admit the sarcasm, however.

[Jon Newman]

Hi Todd,

Now Z advocates have at least one hypothesis to test.

Isolated joint mobility exercises preceding integrated or complex multi-joint movements leads to better performances faster than performing integrated or complex multi-joint movements alone.

or

Integrated movement will necessarily lead to compensations and “cheating” that will fail to correct poor coordination at the weak joints in the movement chain.

Why is Z training worth the money? First of all, I don’t really see how this question is relevant for a board devoted to science and not consumer protection.

I agree with Jason that no one here has overtly stated their activities are related to consumer protection however upon reflection I feel very motivated by consumer protection (and science can and should be used to inform such protection) and I hope this site can be an increasingly valuable resource along these lines. Sometimes the best protection is a good understanding. As with anything, the skills needed to make these types of appraisals take some time to develop and fumbles do occur.

I also disagree that “no personal attacks occurred”

Criticizing the claims and marketing style of zhealth (the marketing is all that is offered for free to the public) is not a personal attack. I agree that sarcasm, cynicism can be found in posts and I'm coming to accept that that is simply how people express themselves. On the other hand, like yourself, I also don't have a problem pointing out that it exists when I perceive it has taken on a life of its own and is becoming particularly corrosive to achieving some understanding--hypocrisy be damned.

[bernard]

it was stated that “Z is an abbreviation for zero”;

I'm guilty. :angel: I often use cynism and humor.

a “five year old” mentality

I didn't said that at all. I just pointed out that the brought evidences were such evidences that all PT learn.
BTW, I was unable to find a single link with the Z thing (I'm sarcastic ).

So my comment remains the same : The books by Hanna and Feldenkrais teach the same stuff for less than 20$. They bring more explanation than the vague words written here by the Z crowd.

This is not hostility but simple evidence.
I can't revise my first opinion about the abbreviation.

[Randy Dixon]

Todd,

I've been telling these guys forever that if they actually want people to hang around and participate that they need to lighten up on the hostility. The perception of individuals presenting to this group and getting ganged up on is much different than the perception of the gang. The fact that the gang is also basically calling "BULLSHIT!" doesn't make it any easier on those who are bringing in the ideas. We should keep that in mind.

On the other hand, and I always seem to have at least one other hand, the claims made by Z-health are pretty outrageous, you will not see claims like this in any scientific journal for any procedure or technique, so they can't be expected to be taken as reasonable or scientific but marketing hype. Anti-marketing hype should be expected to be of a similar tone.

I think I've already expressed my views about Z-health. I wonder why you dismiss the claims and are so sceptical about Crossfit, Probodx, Egoscue etc. They have explanations and testimonials that are roughly equivalent to Z-health. I am sure that any practitioner on this forum of these systems finds your dismissal insulting.

See the dilemma? (and yes, it is with two m's)

[bernard]

I've been telling these guys forever that if they actually want people to hang around and participate that they need to lighten up on the hostility.

Randy, that's true and I have a simple, logical and scientific explanation that explains the found hostility.

You may call it: Patience lost.
158 posts and we are still waiting for a single response that feeds the theory.

We waited the same way for myofascial "method" evidence.

Perhaps, the outrageous way Z crowd presents claims lets us make shortcuts and time revealed that we were not really wrong. :angel:

BTW, I will never call it premonition, probably intuition or an ability to find flaws at an incredible speed.

[Diane]

Randy, re: your first paragraph, if that's what you truly think about us, why are you still here?

[bernard]

Diane,

I understand Randy, anyway.
I think that we aren't serious people at all but he knows that our comments and inquiries are made seriously.

It is remains true that SomaSimple tone is coloured in the way we share some scientific aspects about human functionning.
And it is true that we have some difficulty to accept others that present concepts that do not fit our point of view.

[Jason Silvernail]

Bernard-

And it is true that we have some difficulty to accept others that present concepts that do not fit our point of view.

What point of view would that be? I see in the moderators of this site quite varied treatment approaches and styles. The only thing that holds us together is our commitment to scientific principles and intelligent theory that we feel should underlie modern practice.
If that breeds some hostility (which I haven't seen here) toward nonscientific approaches that can't be explained intelligently, then that seems perfectly appropriate to me.
I thought that was our job as scientists.

[bernard]

What point of view would that be?

The scientific point of view, of course. :embarasse

[Diane]

Jason, :thumbs_up:thumbs_up:thumbs_up:thumbs_up:thumbs_up